BURDEN AND CHARACTERISTICS OF ACUTE TRANSFUSION REACTIONS IN TRANSFUSION-DEPENDENT THALASSEMIA MAJOR PATIENTS

Abstract

Background: Patients with transfusion-dependent beta-thalassemia major (β-TM) are at significant risk of acute transfusion reactions (ATRs) due to lifelong exposure to blood products. This study aimed to determine the frequency and types of ATRs among multi-transfused thalassemic patients in Khyber Pakhtunkhwa (KPK), Pakistan.

Materials and Methods: A descriptive cross-sectional study was conducted at the Hamza Foundation Welfare Hospital and Thalassemia Center, Peshawar. Data were collected from the medical records of 294 registered β-TM patients using a pre-designed questionnaire. All patients were transfusion-dependent and had received multiple packed red cells concentrate (RCC) transfusions, cross-matched via the Jell card method. Statistical analysis was performed using SPSS version 20.0.

Results: The mean age of participants was 12.52 years (range: 2–35 years), with 158 (53.7%) males and 136 (46.3%) females. The most common blood group was B+ (32.7%). Febrile non-hemolytic transfusion reactions (FNHTRs) were observed in 71 patients (24.1%), with fever (19.4%), chills (2.7%), headache (1.4%), vomiting (0.3%), and tachycardia (0.3%) being reported. Allergic reactions occurred in 8 patients (2.7%), manifesting as facial flushing (1.7%), hives/rashes (0.7%), and severe wheezing (0.3%). No hemolytic reactions, tachypnea, anxiety, bradycardia, chest pain, or hematuria were documented.

Conclusion: FNHTRs and mild-to-moderate allergic reactions are the most common acute transfusion complications in multi-transfused thalassemia major patients. Immediate recognition and evidence-based management of these reactions are essential to improve patient safety. The implementation of standardized transfusion protocols, leukoreduction, and vigilant monitoring is recommended to mitigate these adverse events.